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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Both acquired immunodeficiency syndrome (AIDS) surveillance data and surveys on the seroprevalence of human immunodeficiency virus (HIV) indicate that HIV infection through heterosexual transmission is showing a trend of dramatic increase among US women. In women, especially pregnant women, AIDS has a more fulminant course than in men and there is a shorter survival time from diagnosis to death. Gynecologists may be the first source of medical contact among asymptomatic HIV-positive women, and primary care providers should aware of unusual gynecologic manifestations of HIV infection. Protracted herpes infection, refractory vaginal candidiasis, and widespread condylomata often represent early warning signs of an underlying immunocompromised state. Women with impaired cellular immunity are at greater risk of genital papillomavirus and neoplasia. Deficient cellular immunity also facilitates activation of latent infections such as cytomegalovirus, herpes simplex, and papillomavirus. Pelvic inflammatory disease is found in a disproportionately high number of HIV-infected women, although it is unknown whether the inflammation is secondary to the AIDS virus or a co-factor. Genital ulcers both increase the risk of HIV seroconversion and enhance the infectiousness of women already HIV-positive. Herpes simplex and other gynecologic conditions are likely to be more fulminant in presentation, more protracted in course, and resistant to conventional therapy in HIV-infected patients. To facilitate the early identification and treatment of these conditions, Pap smears should be taken every 4-6 months in infected women and there should be liberal use of colposcopy. Oral contraceptive users should be advised to switch to condom/nonoxynol-9 use to reduce the potential for disease transmission and accelerated progression.
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PMID:Primary care of women infected with the human immunodeficiency virus. 224 90

Recent epidemiologic studies have implicated genital/anorectal ulcer disease as an important cofactor for acquisition and transmission of human immunodeficiency virus (HIV) during sexual intercourse. To better understand the mechanism for the association between genital ulcers and HIV, exudates from 62 genital ulcers of 56 HIV-seropositive prostitutes in Nairobi (Kenya) were cultured for HIV. Twenty-six ulcer cultures could not be evaluated for the presence of HIV because of bacterial or fungal contamination. HIV was isolated from 4 (11%) of the 36 remaining uncontaminated ulcer cultures (2 introital, 1 vaginal, and 1 cervical) from 4 separate women. HIV was isolated from the cervical os from only 2 of the 4 women. HIV p24 antigen was detected in exudate from 1 of the 4 culture-positive ulcers and 0 of 32 culture-negative ulcers. Genital ulcers in seropositive patients should be regarded as potential sources of HIV, which could be important in transmission of HIV during intercourse. Public health measures aimed at controlling sexually transmitted genital ulcer diseases should be an integral part of acquired immunodeficiency syndrome (AIDS) prevention programs.
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PMID:Isolation of human immunodeficiency virus from genital ulcers in Nairobi prostitutes. 276 Apr 95

Heterosexual transmission of the human immunodeficiency virus (HIV) appears to occur readily in Africa but less commonly in North America and Europe. We conducted a case-control study among men attending a clinic for sexually transmitted diseases in Nairobi to determine the prevalence of HIV infection and the risk factors involved. HIV antibody was detected in 11.2 percent of 340 men who enrolled in the study. Reports of nonvaginal heterosexual intercourse and homosexuality were notably rare. Recent injections and blood transfusions were not associated with HIV infection. Travel and frequent contact with prostitutes were associated with HIV seropositivity. Men who were uncircumcised were more likely to have HIV infection (odds ratio, 2.7; P = 0.003), as were those who reported a history of genital ulcers (odds ratio, 7.2; P less than 0.001). A current diagnosis of genital ulcers was also associated with HIV seropositivity (odds ratio, 2.0; P = 0.028). Multivariate analysis revealed an independent association of genital ulcers with HIV infection in both circumcised and uncircumcised men. Uncircumcised men were more frequently infected with HIV, regardless of a history of genital ulcers. Our study finds that genital ulcers and an intact foreskin are associated with HIV infection in men with a sexually transmitted disease. Genital ulcers may increase men's susceptibility to HIV, or they may increase the infectivity of women infected with HIV. The intact foreskin may operate to increase the susceptibility to HIV.
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PMID:Human immunodeficiency virus infection among men with sexually transmitted diseases. Experience from a center in Africa. 339 82

A cross-sectional study among female sex workers in Abidjan was conducted to study the association between sexually transmitted diseases and human immunodeficiency virus (HIV) infection and HIV-related immunosuppression. Among 1209 women tested for HIV, 962 (80%) were seropositive. HIV infection was independently associated with a longer duration of sex work, a lower price for intercourse, being an immigrant, and having a positive Treponema pallidum hemagglutination test (P < .05). Genital ulcers (25% vs. 5%), genital warts (14% vs. 4%), Neisseria gonorrhoeae (32% vs. 16%), Trichomonas vaginalis (27% vs. 17%), and syphilis (27% vs. 17%) were more frequent (P < .05) in HIV-infected than -uninfected women. Among HIV-infected women, the proportions with a genital ulcer were 17%, 25%, and 36% for those with > 28%, 14%-28%, and < 14% CD4 cells, respectively (P < .001). This study suggests that genital ulcers are an opportunistic disease in female sex workers in Abidjan.
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PMID:Genital ulcers associated with human immunodeficiency virus-related immunosuppression in female sex workers in Abidjan, Ivory Coast. 869 87

Genital ulcers are implicated as a risk factor enhancing susceptibility to human immunodeficiency virus type 1 (HIV-1) infection. A prospective study to determine the incidence of and risk factors associated with acquisition of HIV-1 in women with genital ulcers was done. HIV-1-seronegative women with genital ulcers attending a clinic for sexually transmitted diseases in Nairobi were followed to HIV-1 seroconversion over a 6-month period. Of 81 women, 10 seroconverted to HIV-1. The crude 6-month incidence of HIV-1 infection was 12%. Risk factors associated with seroconversion included cervical ectopy (rate ratio [RR], 4.9; 95% confidence interval [CI], 1.5-15.6) and pelvic inflammatory disease (RR, 6.3; 95% CI, 1.9-20.4). Thus, cervical ectopy and pelvic inflammatory disease may increase susceptibility to HIV-1 in women with genital ulcers.
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PMID:Human immunodeficiency virus type 1 seroconversion in women with genital ulcers. 765 94

Sexually transmitted diseases (STD) constitute a frequent presenting complaint. The epidemiology of human immunodeficiency virus (HIV) infection is identical to that of STD and must therefore be systematically investigated in the presence of any STD. Chlamydia trachomatis (CT) is involved in the majority of cases of urethritis and epididymitis in young subjects and is present in the urethra of 10% of subjects with a genital ulcer. Genital ulcers are due to either Treponema Pallidum, Haemophilus ducreyi, or Herpes simplex virus: there is little clinicobacteriological correlation and it is therefore essential to perform laboratory examinations in order to establish the diagnosis. The prevalence of venereal vegetations due to HPV viruses has increased markedly over recent years and require effective treatment and surveillance because of the risk of carcinoma induced by viral oncogenesis. Other viral diseases such as hepatitis B are also classified as STD. The main diagnostic techniques used at the present time for each STD are reviewed and the consensually accepted therapeutic protocols are also proposed.
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PMID:[Sexually transmitted diseases in men]. 876 5

Due to the fact that an overwhelming majority of patients with Acquired Immune Deficiency Syndrome (AIDS) acquired the infection through sexual contact, it comes as no surprise that the same populations who are at increased risk for various sexually transmitted diseases (STDs) also experience high rates of human immunodeficiency virus (HIV) infection. There is increasing evidence that some STDs may enhance the efficiency of sexual transmissions of HIV. Genital ulcers are among the genital syndromes most convincingly implicated as cofactors for potential sexual transmission of HIV. Several cross-sectional studies among heterosexual men and women in Africa originally revealed that both a history of and the presence of genital ulcers was correlated with HIV infection. These findings are complemented by those of a study of HIV infection in homosexual men in the US. This study reports a strong association between HIV antibodies and a history of syphilis and of oral or anogenital herpes. The association between HIV antibodies and genital ulcers remained after controlling for the level of sexual activity. A prospective study conducted in Nairobi provided evidence that genital ulcers, particularly chancroid, increase the susceptibility to HIV infection among women. Another prospective study in Nairobi of men who acquired an STD from a group of prostitutes known to have a very high rate of HIV infection found that men who acquired genital ulcers had 5 times the rate of HIV infection as men who acquired urethritis. In the same cohort of prostitutes, "chlamydia trachomatis" infection also increased the risk of acquisition of HIV. Effective and inexpensive antimicrobial therapy is available for most bacterial STDs. Programs for the diagnosis and treatment of STDs should be integrated into AIDS control programs. The AIDS epidemic should not become a reason for decreasing support for STD control programs but rather an incentive to initiate or strengthen such programs.
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PMID:AIDS: the impact of other sexually transmitted diseases. 1228 Sep 52

Chancroid is a sexually transmitted disease (STD) caused by the Gram negative bacterium Haemophilus ducreyi and is characterised by necrotising genital ulceration which may be accompanied by inguinal lymphadenitis or bubo formation. H ducreyi is a fastidious organism which is difficult to culture from genital ulcer material. DNA amplification techniques have shown improved diagnostic sensitivity but are only performed in a few laboratories. The management of chancroid in the tropics tends to be undertaken in the context of syndromic management of genital ulcer disease and treatment is usually with erythromycin. A number of single dose regimens are also available to treat H ducreyi infection. Genital ulceration as a syndrome has been associated with increased transmission of human immunodeficiency virus (HIV) infection in several cross sectional and longitudinal studies. Effective and early treatment of genital ulceration is therefore an important part of any strategy to control the spread of HIV infection in tropical countries.
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PMID:Chancroid: clinical manifestations, diagnosis, and management. 1257 20

Herpes simplex virus proteins interact with host (human) proteins and create an environment conducive for its replication. Genital ulceration due to herpes simplex virus type 2 (HSV-2) infections is an important clinical manifestation reported to increase the risk of human immunodeficiency virus type 1 (HIV-1) acquisition and replication in HIV-1/HSV-2 coinfection. Dampening the innate and adaptive immune responses of the skin-resident dendritic cells, HSV-2 not only helps itself, but creates a "yellow brick road" for one of the most dreaded viruses HIV, which is transmitted mainly through the sexual route. Although, data from clinical trials show that HSV-2 suppression reduces HIV-1 viral load, there are hardly any reports presenting conclusive evidence on the impact of HSV-2 coinfection on HIV-1 disease progression. Be that as it may, understanding the interplay between these three characters (HSV, host, and HIV-1) is imperative. This review endeavors to collate studies on the influence of HSV-derived proteins on the host response and HIV-1 replication. Studying such complex interactions may help in designing and developing common strategies for the two viruses to keep these "partners in crime" at bay.
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PMID:Herpes Simplex Virus: The Interplay Between HSV, Host, and HIV-1. 2633 Dec 65